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Conditions Related to Vitiligo

Posted on December 4, 2019

People with vitiligo may have a higher risk for developing some other health conditions. Vitiligo is an autoimmune condition – a condition caused by the immune system malfunctioning and attacking a person’s own tissues.1 Approximately 15 to 25 percent of people with vitiligo have another autoimmune condition.2 Those with vitiligo are also more likely to have a family member with an autoimmune disease.1 For these reasons, many researchers believe that inherited genes are important risk factors for developing vitiligo in some people.1

When someone has more than one disease occurring at the same time, the conditions are known as comorbidities. Learning about the most common comorbidities of vitiligo may help you recognize potential symptoms and know when to talk to your doctor.

Autoimmune Thyroid Diseases

Autoimmune thyroid diseases are among the most common autoimmune diseases found in people with vitiligo.3 The thyroid is a small, butterfly-shaped gland at the front of the neck.4 The thyroid releases hormones that help regulate your mood, digestive function, muscle control, bone density, and heart function.4

Types of autoimmune thyroid disease that can occur with vitiligo include:

  • Hashimoto thyroiditis3
  • Graves’ disease3
  • Addison's disease2

Autoimmune thyroid diseases can cause both hyperthyroidism (too much thyroid hormone) and hypothyroidism (too little thyroid hormone), which have opposite symptoms. If you notice any of the following, discuss your symptoms with your doctor.

Symptoms of hyperthyroidism:4

  • Weight loss
  • Increased appetite
  • Increased bowel movements
  • Rapid or irregular heartbeat
  • Tremors
  • Irritability
  • Prominent eyes with retracted lids and a “staring” appearance

Symptoms of hypothyroidism:4

  • Weight gain
  • Reduced appetite
  • Low heart rate
  • Muscle stiffness
  • Depression
  • Intolerance of cold temperatures

Skin, Muscle, and Joint Conditions

Vitiligo is associated with several autoimmune conditions that primarily attack the skin, muscles, joints, and connective tissue.

Sjögren’s syndrome1
Sjögren’s (pronounced SHOW-grins) syndrome is an autoimmune condition that can affect the whole body.5 Sjögren’s often causes chronic dryness of the eyes, nose, mouth, and skin.5 Sjögren’s can also lead to eye discomfort and infections, mouth sores and dental issues, difficulty swallowing, and lung problems.5

Lupus1
Systemic lupus erythematosus, commonly known as lupus, can cause a wide variety of symptoms and affects each person differently. Some of the most common symptoms of lupus are:6

  • Extreme fatigue
  • Painful, swollen joints
  • Butterfly-shaped rash across the cheeks and nose
  • Sensitivity to sun or light in general
  • Sores in the mouth or nose
  • Edema (swelling) in the hands, legs, feet, and around the eyes

Learn more about lupus.

Psoriasis1
Symptoms of psoriasis include red, scaly patches of skin that can itch, burn, or sting.7 Psoriasis can appear anywhere on the body, but the elbows, knees, and scalp are some of the most common areas affected.7

Learn more about psoriasis.

Rheumatoid arthritis1
Rheumatoid arthritis causes pain, swelling, tenderness, and stiffness in the joints. Joint pain caused by rheumatoid arthritis typically:8

  • Lasts for six weeks or more
  • Affects more than one joint
  • Affects small joints (for instance the wrists, hands, or feet)
  • Occurs in the same joints on both sides of the body

With rheumatoid arthritis, joints are likely to be stiff in the morning.8 Learn more about rheumatoid arthritis.

Myasthenia gravis1
In myasthenia gravis, autoimmune attacks disrupt the connection between the nerves and muscles, resulting in muscle weakness.9 Myasthenia gravis may affect the muscles that control the eyes and eyelids first.9 Common symptoms of myasthenia gravis include:9

  • Droopy eyelids
  • Double vision
  • Trouble chewing, swallowing, or holding up the head
  • Weakness in the arms, legs, and muscles involved in breathing

Symptoms may come and go and shift from mild to severe repeatedly.9

Gastrointestinal Conditions

Autoimmune diseases of the digestive system can also affect those with vitiligo at higher rates than the general population. Crohn’s disease, ulcerative colitis, type 1 diabetes, and pernicious anemia are all more likely to develop in those with vitiligo.1

Crohn’s disease and ulcerative colitis1
Crohn's disease and ulcerative colitis are known collectively as inflammatory bowel disease or IBD. Both Crohn’s and colitis can cause persistent diarrhea, bloody stool, urgent need to defecate, and abdominal pain and cramps.10,11

Learn more about Crohn’s disease and ulcerative colitis.

Type 1 diabetes1
In type 1 diabetes, the immune system destroys the cells in the pancreas that make insulin.12 Without insulin, your blood glucose (also called blood sugar) levels rise.12 People with type 1 diabetes require insulin via daily injections or through an insulin pump to stay alive.12 Type 1 diabetes usually develops in children and young adults, but it can develop at any age.12

Symptoms of type 1 diabetes include:12

  • Increased thirst
  • Increased urination
  • Increased hunger
  • Fatigue
  • Blurry vision
  • Weight loss

Pernicious anemia1
People with pernicious anemia lack a protein called intrinsic factor that is made in the stomach.13 Intrinsic factor allows the body to absorb vitamin B12, which is necessary to make red blood cells.13 People with pernicious anemia cannot make enough red blood cells because they cannot absorb vitamin B12.13

Symptoms of pernicious anemia include:13

  • Fatigue
  • Pale or yellowish skin
  • Shortness of breath
  • Cold hands and feet
  • Chest pain

Talking to Your Doctor

If you or a loved one have vitiligo and you are concerned about a comorbid condition, talk to your doctor. You might consider keeping track of any worrying symptoms over time and asking close relatives whether they have been diagnosed with any autoimmune conditions. Gathering this information in advance may help your doctor better assess your risk for a comorbid condition, since taking personal and family health history is often an important step in diagnosis.

Condition Guide

In partnership with the Global Vitiligo Foundation, which strives to improve the quality of life for individuals with vitiligo through education, research, clinical care, and community support.

References
  1. Elbuluk, N., & Ezzedine, K. (2017). Quality of Life, Burden of Disease, Co-morbidities, and Systemic Effects in Vitiligo Patients. Dermatologic Clinics, 35(2), 117–128. doi:10.1016/j.det.2016.11.002
  2. Vitiligo - Genetics Home Reference - NIH. U.S. National Library of Medicine. Retrieved December 2019, from https://ghr.nlm.nih.gov/condition/vitiligo.
  3. Baldini, E., Odorisio, T., Sorrenti, S., Catania, A., Tartaglia, F., Carbotta, G., … Ulisse, S. (2017). Vitiligo and Autoimmune Thyroid Disorders. Frontiers in Endocrinology, 8, 1–6. doi:10.3389/fendo.2017.00290
  4. Thyroid gland. You and Your Hormones. Retrieved December 2019, from https://www.yourhormones.info/glands/thyroid-gland/.
  5. Administrator. (n.d.). Sjögren's Syndrome Foundation - Symptoms. Retrieved December 2019, from https://www.sjogrens.org/home/about-sjogrens/symptoms.
  6. Common symptoms of lupus - Lupus Foundation of America. (n.d.). Retrieved December 2019, from https://www.lupus.org/resources/common-symptoms-of-lupus.
  7. About Psoriasis | National Psoriasis Foundation. (n.d.). Retrieved December 2019, from https://www.psoriasis.org/about-psoriasis.
  8. Rheumatoid Arthritis Symptoms - Arthritis Foundation. (n.d.). Retrieved December 2019, from https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/symptoms.php.
  9. Myasthenia Gravis (MG) - Muscular Dystrophy Association. (2019, November 12). Retrieved December 2019, from https://www.mda.org/disease/myasthenia-gravis.
  10. Signs and Symptoms of Crohn's Disease - Crohn's & Colitis Foundation. (n.d.). Retrieved December 2019, from https://www.crohnscolitisfoundation.org/what-is-crohns-disease/symptoms.
  11. Signs and Symptoms of Ulcerative Colitis - Crohn's & Colitis Foundation. (n.d.). Retrieved December 2019, from https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis/symptoms.
  12. Type 1 Diabetes - National Institute of Diabetes and Digestive and Kidney Diseases. (2017, July 1). Retrieved December 2019, from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-1-diabetes.
  13. Pernicious Anemia - National Heart Lung and Blood Institute. (n.d.). Retrieved December 2019, from https://www.nhlbi.nih.gov/health-topics/pernicious-anemia.
  14. Rodrigues, M. (2017). Skin Cancer Risk (Nonmelanoma Skin Cancers/Melanoma) in Vitiligo Patients. Dermatologic Clinics, 35(2), 129–134. doi: 10.1016/j.det.2016.11.003
Posted on December 4, 2019
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Richard H. Huggins, M.D., Treasurer of the Global Vitiligo Foundation is the author of numerous journal articles and chapters studying treatments and quality of life for people with vitiligo and other skin conditions. Learn more about him here.
Kelly Crumrin is a senior editor at MyHealthTeam and leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

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